We are living in a time of immense uncertainty and confusion, a situation that is compounded by how quickly information (and misinformation) can spread on social media. Recently, misinterpretation of CDC data generated widespread confusion around COVID-19 mortality statistics. We know our alumni are often looked to as trusted sources of medical information by their patients, loved ones, friends, and communities, and I want to share some information that may help you sort through this complex topic.

In the CDC report that caused so much controversy, the agency noted that COVID-19 was “the only cause specifically mentioned” on death certificates in just 6% of deaths involving the virus. In the other 94% of cases, other concomitant illnesses (heart failure, respiratory failure, cardiac arrest, etc.) were listed as the cause of death in the setting of illness caused by COVID-19.

As many of us know, what gets listed as the cause of death on a death certificate is not always straightforward. A patient may have metastatic cancer and suffer a fatal heart attack. Did the patient die of metastatic cancer or heart attack? It almost certainly didn’t help that he or she had cancer, but the heart attack is probably what gets listed on the death certificate. But when you determine cause of death or attributable mortality, you have to think about the most direct route to that outcome. In the case of COVID-19, just because people had underlying comorbidities doesn’t mean that it wasn’t COVID that killed them. In other words, the comorbidity—obesity, diabetes, COPD, emphysema—might otherwise have been managed if not for the COVID-19. But in many cases, the underlying conditions undermined the immune system’s ability to respond to COVID (we know this is especially prevalent with diabetes and cancer).

When something like COVID-19 is listed as the cause of death on a death certificate, that’s a very specific diagnosis that has to meet very specific criteria. Numerous analyses have shown that deaths in the U.S. are above normal, attributable to COVID-19. For example, there were 215,000 more U.S. deaths from March-July compared to the baseline, and 71% of these were diagnosed specifically as COVID-19 deaths by the patients’ physicians.

It is important to me that, as an alumnus and a trusted voice in your community, you have accurate information to share with those who turn to you for counsel. I hope you find this message useful as you help your patients and loved ones navigate the often bewildering circumstances in which we are living.